A 34-year-old woman is admitted to the hospital with a diagnosis of acute appendicitis. She started having right lower quadrant abdominal pain approximately 30 hours earlier but did not go to the hospital because she thought the pain would subside on its own. The patient had no food, only sips of water, during that time. Blood pressure is 115/72 mm Hg and pulse is 106/min. Mucous membranes are dry and there is tenderness in the right lower quadrant of the abdomen. Laboratory evaluation shows mild leukocytosis, normal serum electrolytes, borderline low serum glucose levels, and moderate ketones in the urine. Based on the evaluation, it is suspected that this patient is utilizing ketone bodies as a significant reserve of energy. Which of the following tissues cannot use this energy source?

Question

A 34-year-old woman is admitted to the hospital with a diagnosis of acute appendicitis.  She started having right lower quadrant abdominal pain approximately 30 hours earlier but did not go to the hospital because she thought the pain would subside on its own.  The patient had no food, only sips of water, during that time.  Blood pressure is 115/72 mm Hg and pulse is 106/min.  Mucous membranes are dry and there is tenderness in the right lower quadrant of the abdomen.  Laboratory evaluation shows mild leukocytosis, normal serum electrolytes, borderline low serum glucose levels, and moderate ketones in the urine.  Based on the evaluation, it is suspected that this patient is utilizing ketone bodies as a significant reserve of energy.  Which of the following tissues cannot use this energy source?

Quizplus · Accepted Answer

Eductional Objective: When glycogen stores are depleted during fasting, ketone bodies are produced in the liver and can be used as an energy source in the mitochondria of peripheral tissues.  The brain preferentially uses glucose, but will utilize ketones for most of its energy needs during prolonged starvation.  Erythrocytes lack mitochondria and are unable to use ketones.

A 34-Year-Old Woman Is Admitted to the Hospital with a Diagnosis